What Are Bunions? A Podiatrist Explains the Causes and Treatment
Share
A podiatrist explains what bunions are, what causes that bump at the base of the big toe, and how they are treated.
By Jason McLellan, Co-Owner & Paediatric Podiatrist, Little Big Feet Podiatry, Brisbane
Key Facts
- What it isA change in position of the big-toe joint (hallux abducto-valgus) that leaves a bony bump on the side of the foot.
- Most at riskPeople with a family history, and those with arthritis or developmental foot differences, with ill-fitting shoes making it worse.
- Common symptomsA visible bump at the base of the big toe, pain and irritation at the joint, and trouble finding shoes that fit.
- Primary treatmentRoomy, bunion-friendly footwear, insoles or orthotics, in-shoe padding or splinting, with surgery reserved for severe cases.
What are bunions?
A bunion (hallux abducto-valgus) is a change in position of the big-toe (first metatarsal phalangeal) joint, resulting in a protrusion or enlargement. The onset of bunions may be during either childhood (juvenile HAV) or adulthood. Whilst bunions may be exacerbated by ill-fitting footwear and poor footwear selection, many factors such as family hereditary, arthritis and developmental abnormalities may contribute to bunion formation.
How are bunions treated?
Bunions are problematic as they can cause acute or chronic pain, irritation and difficulty in footwear, and functional compensations. Bunions may be treated conservatively or surgically. The prognosis and treatment pathway of a bunion will depend on several factors such as: the degree and severity of the deformity, the age of the patient, and the range and quality of movement at the joint. Podiatrists offer conservative treatment pathways which may include: footwear recommendations, insoles/orthotics, in-shoe modifications, splinting and/offloading.
The Comfort Co Breakdown
Bunions, in plainer English
A bunion is a deformity of the big-toe joint that can cause pain, irritation, and difficulty with footwear. The joint shifts out of line, the big toe leans toward the smaller toes, and a bony bump forms on the inside edge of your foot.
Why did I get a bunion?
Genetics. Bunions often run in families, so the foot shape that leads to them can be something you inherit.
Foot structure and arthritis. How your joints are built, and conditions like arthritis, can push the joint out of alignment over time.
Footwear. Tight, narrow or pointed shoes do not create a bunion out of nothing, but they can irritate it and speed it along.
What happens if I ignore it?
Bunions tend to be progressive, so the bump can grow, the joint can get sorer, and shoes get harder to wear. Getting the footwear right early keeps you comfortable and can slow the whole thing down.
Written by The Comfort Co team.
Symptoms, timeline and self-care
Bunions build slowly, and how much they bother you often comes down to the shoes you put them in.
The tell: a bump and a drifting big toe
The clearest sign is a bony bump on the inside of the foot at the base of the big toe, with the big toe angling toward the others. The joint can be sore, red or swollen, and firm or pointed shoes tend to aggravate it.1
How it progresses
Bunions usually develop gradually and can worsen over the years, which is why easing pressure early matters. Conservative care does not reverse the bony change, but it can reduce pain and irritation and help you stay in comfortable shoes for longer.2
What you can do at home
Choose shoes with a wide, rounded toe box and soft uppers, skip narrow and pointed styles, and use padding or a bunion sleeve to protect the joint. A supportive insole can steady how the foot loads and take some pressure off the area. If it is painful or changing, have it assessed.2
The Comfort Co Solutions
Do not let your bunions set you back. We have a range of footwear and support ready to help you find relief straight away, and it starts with giving that joint the room it needs.
1. Give the joint room with a wide fit
The single best thing you can do is get the toes out of a squeeze. Browse the wide fit collection for roomy styles, and look at Revere, which designs with bunions front of mind. The Timaru and Naples styles both have a neoprene panel built in to cover and accommodate the bunion area.
2. Add targeted bunion relief
OS1st makes support built for this exact spot. The BR4 bunion relief sock has a split toe and bunion pad for comfort no matter your activity, and the HV3 bracing sleeve is an ultra-light splint for resting, realigning the toe angle and easing forefoot swelling.
3. Go for maximum accommodation
If you want the roomiest option going, look at Anodyne. Designed for diabetic feet, they come with extra width, no interior stitching and plush linings, which makes them ideal for accommodating a bunion too.
Comfort Co Pro Tip
Shop for shoes late in the day when your feet are at their largest, and buy for the widest part of your foot. A bunion needs room across the joint, not just length, so let the toe box do the deciding.
Keep Reading
Quick questions
What do bunions look and feel like?
A bunion shows up as a bony bump on the inside of the foot at the base of the big toe, with the big toe angling toward the smaller toes. The joint can be sore, red or swollen, and it often makes some shoes uncomfortable.
What causes bunions?
Bunions are usually driven by genetics, foot structure and conditions like arthritis. Tight, narrow or pointed shoes do not create a bunion on their own, but they can irritate the joint and speed its progression.
Can bunions be fixed without surgery?
Conservative care does not reverse the bony change, but roomy footwear, insoles, padding and splinting can reduce pain and irritation and slow things down. Surgery is generally reserved for severe or persistently painful cases.
What shoes are best for bunions?
Shoes with a wide, rounded toe box, soft uppers and low heels give the joint room and reduce rubbing. Styles with a stretch or neoprene panel over the bunion area, and extra-roomy accommodating shoes, are ideal.
Do bunion splints and socks work?
They will not straighten the joint permanently, but a bunion sleeve or relief sock can ease pressure, protect the area and reduce discomfort day to day. A resting splint can also help settle forefoot swelling.
Sources
- Cleveland Clinic. Bunions (Hallux Valgus). my.clevelandclinic.org
- OrthoInfo, American Academy of Orthopaedic Surgeons. Bunions. orthoinfo.aaos.org